British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Comparison of desflurane with sevoflurane for the incidence of oculocardiac reflex in children undergoing strabismus surgery.
The oculocardiac reflex (OCR) is frequently observed during strabismus surgery. This study was designed to evaluate and compare the effect of sevoflurane and desflurane on the incidence of OCR. ⋯ Both agents can be used safely during strabismus surgery in paediatric patients.
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Randomized Controlled Trial
Cricoid pressure prevents placement of the laryngeal tube and laryngeal tube-suction II.
The laryngeal tube has a potential role in patients with a difficult airway, but cricoid pressure is required if the patient is at risk of aspiration. The effect of cricoid pressure on insertion of these devices is unknown. ⋯ Continuous cricoid pressure prevents correct placement of the laryngeal tube and the laryngeal tube-suction II such that placement and ventilation via these devices are ineffective. The effect of cricoid pressure on ventilation via these devices, after correct placement, remains unknown.
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Experimental evidence from a murine model of traumatic brain injury (TBI) suggests that hypothermia followed by fast rewarming may damage cerebral microcirculation. The effects of hypothermia and subsequent rewarming on cerebral vasoreactivity in human TBI are unknown. ⋯ After moderate hypothermia, rewarming exceeding the 37 degrees C threshold is associated with a significant increase in average PRx, indicating temperature-dependent hyperaemic derangement of cerebrovascular reactivity.
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Information is lacking concerning optimal infusion rates of crystalloid during resuscitation from acute haemorrhage. In this study, a mathematical model was used to predict infusion volume of crystalloid needed to restore and maintain blood volume after acute haemorrhage. ⋯ Bolus crystalloid infusion exceeding 80 ml kg(-1) h(-1) may not increase effectiveness of fluid resuscitation. Crystalloid resuscitation for more than 2 h may be detrimental in view of an excessive net fluid retention.
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Case Reports
Prolonged myotonia and dystonia after general anaesthesia in a patient taking gabapentin.
This is the report of a 55-yr-old female who developed severe myotonia and dystonia after general anaesthesia. Before starting on gabapentin therapy for a neuropathic pain condition, she had undergone numerous uneventful general anaesthetics. ⋯ The events were unrelated to the choice of anaesthetic or anti-emetic. The most recent event that required a protracted stay in hospital after a day-case surgery is presented in detail, and the possible mechanisms to explain the interaction are discussed.